Dental Claims Specialist Job at Beacon Hill (St. Louis)

Dental Claims Specialist

Location

United States , St. Louis

Salary:

21.00 USD / Hour

Beacon Hill

Expiration Date

Until further notice

Requirements

Recent Dental experience is a must have
Health Plan experience is strongly preferred
Familiar with CDT codes and dental terminology
Coordination of Benefits a huge plus
Ability to operate at a fast pace
Strong attention to detail
Must be local to St. Louis, MO

Fulltime

Appeals and Grievances Clinical Specialist

The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, griev...

Location

United States , New York City; Lake Mary

Salary:

73400.00 - 120360.00 USD / Year

Healthfirst

Expiration Date

Until further notice

Requirements

RN, LPN OR Dental Hygienist
Bachelor’s degree
Experience in clinical practice with experience in appeals & grievances, claims processing, utilization review or utilization management/case management
Demonstrated understanding of Utilization Review Guidelines (NYS ART 44 and 49 PHL), InterQual, Milliman or Medicare local coverage guidelines
Ability to work independently on several computer applications such as Microsoft Word and Excel, as well as corporate email and virtual filing system, (ie. Macess)
Experience with care management systems, such as CCMS, TruCare and Hyland
Demonstrated ability to manage large caseloads and effectively work in a fast-paced environment

Job Responsibility

Responsible for case development and resolution of clinical cases, such as: Pre-existing Conditions, Prior Approval, Medical Necessity, Pre-certification, Continued Stay, Reduction, Termination, and Suspension of services
Research issues
Reference and understand HF’s internal health plans policies and procedures to frame decisions
Interpret regulations
Resolve cases and make critical decisions
Update file documentation such as the file notes and case summary
Manage all duties within regulatory timeframes
Communicate effectively to hand-off and pick-up work from colleagues
Work within a framework that measures productivity and quality for each Specialist against expectations
Prepare cases for Medical Director Review ensuring that all pertinent information (i.e. case summary, contract information, internal and external responses, diagnosis, and CPT codes and descriptions) has been obtained during investigation and is presented as part of the case

What we offer

medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions

Fulltime

Appeals and Grievances Clinical Specialist

The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, griev...

Location

United States , New York City; Lake Mary

Salary:

73400.00 - 120360.00 USD / Year

Healthfirst

Expiration Date

Until further notice

Requirements

RN, LPN OR Dental Hygienist
Bachelor’s degree
Experience in clinical practice with experience in appeals & grievances, claims processing, utilization review or utilization management/case management
Demonstrated understanding of Utilization Review Guidelines (NYS ART 44 and 49 PHL), InterQual, Milliman or Medicare local coverage guidelines
Ability to work independently on several computer applications such as Microsoft Word and Excel, as well as corporate email and virtual filing system, (ie. Macess)
Experience with care management systems, such as CCMS, TruCare and Hyland
Demonstrated ability to manage large caseloads and effectively work in a fast-paced environment

Job Responsibility

Responsible for case development and resolution of clinical cases, such as: Pre-existing Conditions, Prior Approval, Medical Necessity, Pre-certification, Continued Stay, Reduction, Termination, and Suspension of services
Research issues
Reference and understand HF’s internal health plans policies and procedures to frame decisions
Interpret regulations
Resolve cases and make critical decisions
Update file documentation such as the file notes and case summary
Manage all duties within regulatory timeframes
Communicate effectively to hand-off and pick-up work from colleagues
Work within a framework that measures productivity and quality for each Specialist against expectations
Prepare cases for Medical Director Review ensuring that all pertinent information (i.e. case summary, contract information, internal and external responses, diagnosis, and CPT codes and descriptions) has been obtained during investigation and is presented as part of the case

What we offer

medical, dental and vision coverage
incentive and recognition programs
life insurance
401k contributions

Fulltime

Appeals and Grievances Clinical Specialist

The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, griev...

Location

United States , New York City; Lake Mary

Salary:

73400.00 - 120360.00 USD / Year

Healthfirst

Expiration Date

Until further notice

Requirements

RN, LPN OR Dental Hygienist
Bachelor’s degree
Experience in clinical practice with experience in appeals & grievances, claims processing, utilization review or utilization management/case management
Demonstrated understanding of Utilization Review Guidelines (NYS ART 44 and 49 PHL), InterQual, Milliman or Medicare local coverage guidelines
Ability to work independently on several computer applications such as Microsoft Word and Excel, as well as corporate email and virtual filing system, (ie. Macess)
Experience with care management systems, such as CCMS, TruCare and Hyland
Demonstrated ability to manage large caseloads and effectively work in a fast-paced environment

Job Responsibility

Responsible for case development and resolution of clinical cases, such as: Pre-existing Conditions, Prior Approval, Medical Necessity, Pre-certification, Continued Stay, Reduction, Termination, and Suspension of services
Research issues
Reference and understand HF’s internal health plans policies and procedures to frame decisions
Interpret regulations
Resolve cases and make critical decisions
Update file documentation such as the file notes and case summary
Manage all duties within regulatory timeframes
Communicate effectively to hand-off and pick-up work from colleagues
Work within a framework that measures productivity and quality for each Specialist against expectations
Prepare cases for Medical Director Review ensuring that all pertinent information (i.e. case summary, contract information, internal and external responses, diagnosis, and CPT codes and descriptions) has been obtained during investigation and is presented as part of the case

What we offer

medical, dental and vision coverage
incentive and recognition programs
life insurance
401k contributions

Fulltime

Medical Accounts Receivable Specialist

This contract-to-permanent position involves managing the full insurance revenue...

Location

United States , Bellevue

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 3 years of experience in healthcare, dental, or medical insurance accounts receivable and revenue cycle management
Proficiency in handling accounts receivable, cash applications, and billing functions
Solid understanding of health care revenue cycle processes, including collections and cash activity
Strong analytical skills to identify issues and implement solutions for claim denials and payment discrepancies
Familiarity with payor-specific regulations and contractual requirements
Ability to manage provider credentialing and enrollment processes efficiently
Excellent communication and collaboration skills to work effectively across teams and departments
Strong attention to detail and organizational skills to maintain compliance and ensure accuracy in all tasks

Job Responsibility

Oversee insurance accounts receivable processes from initial charge posting to final resolution
Investigate and resolve unpaid, underpaid, or denied claims promptly and accurately
Ensure claims meet payor guidelines and adhere to clean-claim standards to prevent revenue loss
Post payments and adjustments with precision and reconcile explanation of benefits to maintain accuracy
Monitor credentialing timelines for providers, ensuring timely enrollment and re-credentialing with contracted payors
Identify and address root causes of claim denials, implementing corrective measures to mitigate recurring issues
Maintain compliance with state regulations, payor contracts, and internal revenue integrity standards
Track and report key revenue cycle metrics, such as denial rates, days in accounts receivable, and net collection ratios
Collaborate with operations leadership and care center teams to resolve reimbursement issues and streamline processes
Serve as the primary liaison for credentialing matters, audits, and compliance reviews related to provider enrollment

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Sr. Benefits Specialist

We are looking for a skilled Sr. Benefits Specialist to join our team in Pasaden...

Location

United States , Pasadena

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 5 years of experience in benefits administration or related roles
Proficiency in managing employee benefit plans, including health, dental, vision, and retirement programs
Strong knowledge of FMLA policies and disability benefits
Experience with ADP Workforce Now or similar HR management systems
Demonstrated ability to analyze and optimize benefits packages
Familiarity with 401(k) administration, including enrollments and reporting
Exceptional organizational and communication skills to manage employee inquiries and data
Ability to ensure compliance with regulatory requirements and company policies

Job Responsibility

Administer comprehensive benefits programs, including health, dental, vision, life, disability, and voluntary options, ensuring accuracy and compliance
Manage employee enrollment processes, handle status changes, and resolve claims efficiently
Maintain updated and accessible benefits resources across internal platforms to support employees
Oversee retirement plans such as 401(k), including enrollments, loans, withdrawals, and reporting
Provide guidance and support to employees regarding FMLA and other leave policies
Collaborate with payroll and HR teams to ensure seamless integration and execution of benefits
Analyze benefit packages and provide recommendations to optimize offerings
Verify and monitor employee benefits to ensure eligibility and accuracy
Utilize ADP Workforce Now to manage benefits administration tasks effectively
Conduct regular audits and reporting to ensure compliance with regulations and company policies

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan

Benefit Specialist

Location

United States , Rochester

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Bachelor’s degree in Human Resources, Business Administration, or related field preferred
2+ years’ experience in employee benefits administration or related HR role
In-depth knowledge of benefit plan types and relevant regulations
Proficient in HRIS systems and Microsoft Office Suite
Strong analytical, organizational, and communication skills
Ability to maintain confidentiality and handle sensitive information with discretion
Exceptional customer service orientation

Job Responsibility

Administer employee benefits programs, including health, dental, vision, life insurance, disability, retirement plans, and wellness initiatives
Serve as the primary contact for employees regarding benefits questions, claims, and coverage issues
Coordinate annual open enrollment activities and facilitate new hire benefit orientations
Process benefits enrollments, changes, and terminations within HRIS and vendor systems accurately and promptly
Collaborate with benefits vendors and brokers to resolve employee issues and manage plan renewals
Maintain compliance with federal, state, and local regulations (e.g., HIPAA, COBRA, ERISA)
Review and reconcile monthly benefits invoices
manage billing discrepancies
Prepare employee communications regarding policy changes, deadlines, and benefit offerings
Support audits of benefits processes and documentation

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Senior HR Specialist

The Senior HR Specialist will play a key role in supporting comprehensive human ...

Location

United States , Clifton

Salary:

Not provided

The Challenge Printing Company Inc

Expiration Date

Until further notice

Requirements

Bachelor’s degree in Human Resources, Business Administration, or a related field (HR concentration preferred)
Minimum of 5 years of progressive HR experience
experience in a manufacturing or regulated environment preferred
Strong working knowledge of federal, state, and local employment laws, with emphasis on New Jersey regulations
Experience administering FMLA and state-specific leave programs
Excellent verbal and written communication, presentation, and interpersonal skills
Strong organizational skills with the ability to multitask and prioritize in a fast-paced environment
Proficiency in Microsoft Word and Excel
Experience with Paylocity or other HRIS systems preferred
High level of professionalism, integrity, and discretion when handling confidential information

Job Responsibility

Administer employee benefit programs, including health, dental, life, disability, workers compensation, FMLA, and COBRA
Serve as a key point of contact for employees with questions regarding benefit plans and assist with claim resolutions
Oversee employee onboarding, orientation, and benefits enrollment
present benefits packages during orientation and facilitate 401(k) education and participation
Ensure employment-related documentation and reports are filed accurately with the appropriate regulatory bodies
Manage compensation programs and coordinate performance evaluations
recommend improvements as necessary
Participate in the review and selection of benefit plan offerings in partnership with senior management
Oversee the recruitment process including job postings, background checks, drug screenings, and E-Verify/I-9 compliance
Maintain and update personnel policies and procedures and ensure adherence to the Employee Handbook

Fulltime

Dental Claims Specialist

Beacon Hill

Location:
United States , St. Louis

Category:
Insurance

Contract Type:
Not provided

Salary:

Job Description:

Requirements:

Nice to have:

Additional Information:

Job Posted:
January 22, 2026

Looking for more opportunities? Search for other job offers that match your skills and interests.

Similar Jobs for Dental Claims Specialist

Dental Claims Specialist

Appeals and Grievances Clinical Specialist

Appeals and Grievances Clinical Specialist

Appeals and Grievances Clinical Specialist

Medical Accounts Receivable Specialist

Sr. Benefits Specialist

Benefit Specialist

Senior HR Specialist

Dental Claims Specialist

Beacon Hill

Location:United States , St. Louis

Category:Insurance

Contract Type:Not provided

Salary:

Job Description:

Requirements:

Nice to have:

Additional Information:

Job Posted:January 22, 2026

Looking for more opportunities? Search for other job offers that match your skills and interests.

Similar Jobs for Dental Claims Specialist

Dental Claims Specialist

Appeals and Grievances Clinical Specialist

Appeals and Grievances Clinical Specialist

Appeals and Grievances Clinical Specialist

Medical Accounts Receivable Specialist

Sr. Benefits Specialist

Benefit Specialist

Senior HR Specialist

Location:
United States , St. Louis

Category:
Insurance

Contract Type:
Not provided

Job Posted:
January 22, 2026